Dentistry A to Z: H is for happy anesthesia
2024-12-20 - 2024-12
As a veterinary dentist with nearly 5 decades of experience, I've amassed more than 53,000 dental and oral cavity images in storage on my laptop. At my wife's encouragement this past November, I ventured beyond my comfort range to focus on a 5-day landscape nature photography trip in Utah's Badlands. The experience broadened my photographic skills and provided unexpected insights into veterinary anesthesia practices.
The transition from handheld dental macrophotography to landscape photography using a tripod and long lenses required adjustments in technique and approach. (Figure 1) This adaptability is necessary in veterinary medicine, where embracing new technologies and equipment is crucial for optimal patient care.
The tripod analogy: Strength in photography and anesthesia
Using a tripod in nature photography can be likened to the foundational principles of successful veterinary anesthesia. Just as a tripod provides stability and support for capturing clear, sharp images, the 3 critical synergistic components of anesthesia-patient evaluation, tailored anesthesia protocols, and vital sign monitoring-form a stable base for safe and effective anesthetic procedures. Client communication is equally important in achieving happy anesthesia results. We need to take the time to explain the necessity of anesthesia for proper dental care, potential risks and benefits, expected recovery time, and postoperative care instructions. This open dialogue helps alleviate owner anxiety and sets realistic expectations for the procedure and recovery process.
Patient evaluation
Similar to assessing the landscape before setting up a shot, thorough preanesthetic evaluation is crucial for identifying potential risks and tailoring the anesthetic approach. The American Veterinary Medical Association and American Animal Hospital Association mandate that all dental procedures be performed under general anesthesia. This makes sense, but how can you transform the anxiety caused by general anesthesia in dentistry into a blissful experience for you and your patients? Start with the physical examination and testing to determine the American Society of Anesthesiologists scoring. In addition to the physical examination and history, the ASA score helps you decide what additional testing is indicated before anesthesia.
The patient assessment may include comprehensive blood work Complete blood cell count, chemistry panel, and electrolytes, urinalysis, chest radiographs for older patients or those with suspected cardiopulmonary issues, and N-terminal pro b-type natriuretic peptide (NT-proBNP). This detailed evaluation helps identify any underlying health concerns affecting anesthesia safety.
One example is our dog KC, a 4-year-old Polish lowland sheepdog, which we had since a puppy and had no clinical signs of kidney disease. It was time for his first professional comprehensive oral prevention, assessment, and treatment visit. His blood tests revealed end-stage kidney disease
Faster claiming for dental attrition when bruxism is involved
2024-12-13 - 2024-12
Since 2007, DVA has introduced policies that allow simpler processing of claims for certain medical conditions where exposures in ADF service, a certain type of ADF service or, in some cases, a previously accepted medical condition are known to meet causal factors. This occurs through policies known as 'streamlining' or 'straight through processing'.
Where a veteran has a diagnosed condition and meets the relevant criteria for application of the policies, usually no further evidence is required to establish a connection between the condition and military service.
As part of this work, DVA has recently added 'dental attrition' arising from bruxism to the list of conditions subject to streamlining. This means that where a veteran has had bruxism accepted as service-related, a claim for dental attrition will be subject to faster processing.
Bruxism is a medical condition that involves excessive tooth grinding or jaw clenching. It can give rise to a separate condition - dental attrition - which involves damage from tooth-to-tooth contact. There are now more than 80 medical conditions subject to these policies, and this change will allow for quicker access to compensation and treatment for dental attrition for eligible veterans who have bruxism caused by service.
Why isn't dental included in Medicare? It's time to change this - here's how
2024-09-22 - 2024-12
When the forerunner of Medicare was established in the 1970s, dental care was left out. Australians are still suffering the consequences half a century later.
Patients pay much more of the cost of dental care than they do for other kinds of care.
More Australians delay or skip dental care because of cost than their peers in most wealthy countries.
And as our dental health gets worse, fees keep on rising.
For decades, a litany of reports and inquiries have called for universal dental coverage to solve these problems.
Now, with the Greens proposing it and Labor backbenchers supporting it, could it finally be time to put the mouth into Medicare?
What's stopping us?
The Australian Dental Association says the idea is too ambitious and too costly, pointing out it would need many more dental workers. They say the government should start small, focusing on the most vulnerable populations, initially seniors.
Starting small is sensible, but finishing small would be a mistake.
Dental costs aren't just a problem for the most vulnerable, or the elderly. More than two million Australians avoid dental care because of the cost.
More than four in ten adults usually wait more than a year before seeing a dental professional.
Bringing dental into Medicare will require many thousands of new dental workers. But it will be possible if the scheme is phased in over ten years.
The real reason dental hasn't been added to Medicare is it would cost billions of dollars. The federal government doesn't have that kind of money lying around.
Australia has a structural budget problem. Government spending is growing faster than revenue, because we are a relatively low-tax country with high service expectations.
The growing cost of health care is a major contributor, with hospitals and medical benefits among the top six fastest-growing major payments.
The structural gap is only likely to grow without major policy changes.
So, can we afford health care for all? We can. But we should do it with smart choices on dental care, and tough choices to raise revenue and reduce spending elsewhere.
Smart choices about a new dental scheme
The first step is to avoid repeating the mistakes of Medicare.
Medicare payments to private businesses haven't attracted them to a lot of the communities that need them the most. Many rural and disadvantaged areas are bulk-billing deserts with too few GPs.
The poorest areas have more than twice the psychological distress of the wealthiest areas, but they get about half the Medicare-funded mental health services.
As a result, government money isn't going where it will make the biggest difference.
There are about 80,000 hospital visits each year for dental problems that could have been avoided with dental care. If there is too little care in disadvantaged and rural communities, where oral health is worst, that number will remain high.
HKU Dentistry Unveils Dental AI Community Care Project
2024-12-17 - 2024-12
HKU Dentistry has launched the Dental AI Community Care Project, addressing the strain on Hong Kong's dental system caused by an aging population and a shortage of dentists. With just 3.7 dentists per 10,000 residents, wait times for dental services can stretch up to 39 months. To tackle this, the Faculty of Dentistry at HKU developed GUM AI, an AI-powered tool that enables rapid oral health screenings and provides customized care advice, boasting over 90% accuracy.
GUM AI simplifies oral check-ups with a color-coded system for clear health indicators. It empowers non-dental professionals, such as trained volunteers, to perform screenings and offer hygiene advice, reducing reliance on dentists and wait times. Supported by community and political stakeholders, the project delivers free gum detection services to elderly individuals in Lam Tin, Sceneway Garden Estate, and other locations.
The initiative emphasizes early detection to lower long-term healthcare costs, improve accessibility for seniors with mobility issues, and promote better oral hygiene awareness. Long-term, the project seeks to expand coverage to all 18 districts, fostering a preventive approach to oral health and easing the burden on Hong Kong's dental system.
Research highlights inadequate dental benefits in Medicare Advantage
2024-12-26 - 2024-12
Medicare Advantage
The privatized form of Medicare that offers benefits beyond traditional Medicare, such as dental insurance is gaining in popularity, but a new analysis reveals that the quality of dental coverage offered by Medicare Advantage is poor, with only 8.4 percent of plans offering a dental benefit that met the study's quality standards.
Simon and her colleagues examined Medicare data from late 2023, and they developed a list of requirements for a comprehensive dental benefit that would be on par with employer-sponsored plans (such as offering dental cleanings without a co-pay, having an annual maximum coverage of at least $1,500, and not requiring an additional premium to have access to these dental services).
The team's analysis included 6,333 Medicare advantage plans with a total enrolment of more than 27 million beneficiaries. The investigators found that 86.6% of plans offered a dental benefit, but only 8.4% offered a comprehensive benefit that met quality standards. Also, 94% of Medicare beneficiaries were enrolled in a plan that offered a dental benefit, but only 4.1% were enrolled in a plan with a comprehensive dental benefit.
These research findings might explain why only about half of Medicare Advantage beneficiaries visit the dentist annually, which is similar to the rate for beneficiaries in traditional Medicare that lacks most dental coverage.
"Many of the attributes we studied-;like how much coinsurance a patient would need to pay or whether procedures like fillings or crowns are covered-;are fairly complex and probably pretty overwhelming for consumers to review during open enrolment season," said Simon. "Regulations could prevent low-quality dental plans from being offered in the first place and ensure that consumers actually know what they're getting when they pick a Medicare Advantage plan."
New denture adhesion solution is inspired by octopus suction cups
2024-12-27 - 2024-12
The study draws inspiration from the adhesive strategies of Octopus vulgaris, whose suction cups excel at gripping surfaces in wet and dry conditions. The researchers replicated the micro-architecture of these suction cups using advanced 3D-printing technologies such as two-photon polymerization and digital light processing. The resulting dentures feature octopus-like micro- and macro topographies, thereby enhancing their ability to adhere to oral tissues.
To further improve adhesion, the surfaces were coated with keratin, a naturally occurring protein known for its hydrophilicity and biocompatibility. This dual strategy of physical and chemical modifications significantly increased adhesive strength in both dry and moist conditions. Notably, the bio-inspired suction cup designs demonstrated higher maximum detachment forces compared with conventional dentures, even when denture adhesives were used.
The study also explored the durability of keratin coatings and their interaction with
oral mucosa. Keratin, extracted from sheep's wool, proved resistant to enzymatic degradation and maintained its adhesive properties over time. Importantly, the research emphasized that keratin's unique chemical composition, including cysteine-rich disulphide bonds, contributes to its superior adhesion by forming strong interactions with mucosal tissues.
This innovation represents a significant advancement for the millions of people worldwide who rely on dentures, particularly the elderly and those with systemic conditions limiting their suitability for dental implants. Poor denture retention often leads to discomfort, difficulty in speaking and eating, and overall dissatisfaction, affecting patients' quality of life. Traditional solutions like adhesive creams are often seen as inconvenient, unhygienic and prone to causing gagging or taste alteration.
The principles of this research have potential applications in medical fields other than dentistry, such as in the development of self-adhesive medical devices, prosthetics and drug delivery systems designed for moist environments. The ability to mimic natural adhesive strategies could lead to more efficient and patient-friendly solutions across healthcare.
New rules aim to ease lack of dentists in many rural parts of France
2024-12-31 - 2024-12
Practices opening in areas with an existing high number of dentists will not receive state reimbursement
New regulations aimed at easing a lack of dentists in many areas of France are to come into force from January 1, 2025.
Dentists will not be granted approval from state insurer Assurance Maladie to work in areas where the number of dentists is considered to be 'very high' or 'high' by the health ministry.
However, they will be granted approval if they set up practice in an area where there is an existing lack of dentists.
Around 65% of communes in France have a 'very low' number of dentists, or none at all, particularly the case in rural areas far from the country's major cities.
The changes have been backed by Franc's main dental unions - together representing 95% of dentists - but some students oppose the rules seeing them as restrictive.
Similar rules may later be applied for doctors as France looks to fight the problem of so-called 'medical deserts' across the country.
Interactive tool shows dentist numbers
From January 1, dentists will still be able to take over existing practices or replace retiring practitioners in areas with already-sufficient dental coverage and maintain state reimbursement.
The new rules also do not prevent someone from opening a practice if it is completely private - it just means the practice will not receive approval from Assurance Maladie and therefore will not be able to reimburse patients for dental work.
As a reminder, state insurance covers 60% of dental fees (as opposed to 70% for many other healthcare needs), with private insurers or optional mutuelles picking up the remaining costs.
Whilst the new rules may sound limiting, in practice less than 5% of areas will be affected, many in larger cities or high-population areas such as Paris and its suburbs, Lyon, and Anglet (the latest data for overseas departments and the south-east of France has not yet been released, but cities there will likely be included in the list).
You can use the health ministry's official Cartosante interactive map to see the level of healthcare professionals near you (click on the 'chirurgiens-dentistes option at the top of the page to see the map for dentists).
Are similar rules for doctors on the way?
A version of these regulations exist for other healthcare professionals such as midwives, nurses, and pharmacists.
The expansion to dentists may pave the way for doctors to also be limited in where they can open practices, encouraging them to work in areas facing a lack of care.
A bill tabled on December 3, 2024, and backed by 237 MPs seeks to prevent doctors from opening a practice in an area with sufficient coverage unless an existing practitioner retires - similar to the new rule for dentists.
The bill was put on the backburner due to the current political instability in France but should be discussed in the next year and is likely to pass, with MPs from all parties backing the original motion.
UK patients unable to get dental care after "eye-watering" rise in private fees
2024-12-31 - 2025-01
Private dentists are cashing in on the scarcity of NHS treatment by hiking their charges for fillings, checkups and extractions to "eye-watering" levels, research has found.
Patients are paying as much as £775 for root canal work, £435 to have a tooth out and £325 for a white filling due to fees for common dental procedures soaring since 2022.
Fees for many treatments have undergone inflation-busting rises in the last two years as more people have been forced to seek non-NHS care, with the average cost of a non-surgical extraction going up by 32%, a comparison of prices at private dental surgeries across the UK has found.
Patient groups warned that some people with dental problems were missing out on care altogether because NHS help is so hard to access and private treatment has become so expensive.
"For patients struggling to access NHS dental care, and for those who choose to go private, the dramatic rise in private dental costs places essential care out of reach for many," said Rachel Power, the chief executive of the Patients Association.
"This creates a dangerous cycle where patients bounce between an inaccessible NHS system and unaffordable private care, while their oral health deteriorates. The stark reality is that many are left with no viable route to essential dental treatment."
Prices have risen dramatically over the last two years, with patients now paying between 14% and 32% more for the same treatments than in 2022, according to research MyTribe Insurance, which tracks the cost of private health insurance and also different types of paid-for health care across the UK.
Their analysis of data covering six common treatments, from 450 private dental practices in 52 UK towns and cities, found that the average cost of:
A white filling has gone from £105 to £129 – up 23%.
An extraction has risen from £105 to £139 – 32% more.
A half-hour scale and polish is now £75, up from £65 – a 15% jump.
An initial consultation for a new patient is up 23% from £65 to £80.
Cold weather amplifies tooth sensitivity, dentists weigh reasons
2025-01-01 - 2025-01
As winter temperatures drop, dental professionals are raising concerns about the rising cases of tooth sensitivity linked to the cold. Known as dentin hypersensitivity, this condition occurs when the protective enamel layer of the teeth erodes, exposing the underlying dentin. This leads to sharp, momentary pain in response to cold stimuli, including ambient temperatures and cold beverages.
Dental sensitivity to cold is not only uncomfortable but can also worsen if left untreated. Experts identify several contributing factors, including improper brushing techniques, frequent consumption of acidic foods and beverages, enamel erosion due to bruxism, and gum recession caused by aggressive oral hygiene practices. Additionally, medical conditions such as acid reflux or bulimia can exacerbate the issue by creating an acidic oral environment.
The impact of cold weather on teeth goes beyond immediate discomfort. Prolonged exposure to extreme temperatures can cause the internal tissues of teeth to expand and contract, potentially leading to microcracks in the enamel and dentin. Over time, this can escalate into severe dental issues.
Dentists recommend maintaining consistent oral hygiene practices, using toothbrushes with soft bristles, and choosing fluoride-based toothpaste designed to protect against sensitivity. Dietary adjustments, such as reducing acidic and sugary foods, along with addressing habits like smoking and teeth grinding, can also help prevent enamel erosion.
In colder months, experts advise breathing through the nose and covering the mouth to limit direct exposure to chilly air. Regular dental check-ups remain crucial for early detection and effective management of tooth sensitivity.
Tooth sensitivity is a common yet preventable issue. Dental professionals emphasize that timely intervention and lifestyle adjustments can significantly alleviate discomfort and protect oral health during winter.
Art meets science: AI helping craft perfect smile
2024-12-14 - 2025-01
New Delhi: In modern dentistry, fears over post-procedure looks have gently faded, whether the path is surgical, non-surgical, or simply cosmetic.
Today, advanced artificial intelligence steps in with a painter's precision, analysing each unique aesthetic detail — the lines and curves of the face, the harmony of proportions, the depth of shade.
With this, a vision of the final smile is brought to life through digital rendering, a glimpse of beauty to come, crafted with art and science entwined.
According to experts, the field of dental care has experienced significant transformation through technological innovation. These advancements have made substantial contributions to elevating dental healthcare standards.
Dr Ashish Kakkar, senior consultant, dental surgery, Indraprastha Apollo Hospitals, said computer-guided implant surgery ensures optimal implant positioning, while piezosurgery enables precise bone cutting with minimal trauma, particularly beneficial for extractions and advanced surgical procedures.
Laser treatments offer reduced bleeding and discomfort compared to conventional methods, particularly in soft tissue procedures and cavity removal.
"The integration of intraoral scanning cameras and digital imaging like photogrammetry has revolutionised diagnostic capabilities by providing instantaneous visualisation of dental conditions, thereby facilitating thorough treatment strategies. These technological advancements have resulted in shorter recovery periods and reduced discomfort, making dental visits more efficient and less daunting for patients," he said.
Dr Shankar Iyer, director of Smile USA and faculty at Rutgers School of Dental Medicine and Jacksonville University, said AI's primary function is prediction.
The technology can be programmed to provide various design features. The pre-programmed algorithms consider facial proportions, arch dimensions and teeth measurements, incorporating these elements to plan and design smiles accordingly.
The system processes aesthetic parameters, including facial proportions and dimensions, as well as teeth length, to calculate and generate smile renderings.
The surgical applications include orthognathic procedures for jaw length modifications or post-cancer reconstructive surgery involving complete jaw replacement. AI enables the creation of 3D printed jaw models, allowing surgeons to prepare with precise computer-designed templates. These templates guide the measurement and harvesting of leg bone tissue for implant placement in reconstructed jaw bone with high predictability and shorten the operatory time considerably.
Virtual orthodontic tooth movement can be done along the same lines, and the planning helps render aligners that enable orthodontic procedures without brackets or braces.
During tooth extractions, a simple procedure involving platelet-rich fibrin (PRF) is often used. A preparation that promotes bone growth, PRF serves as a foundation and scaffold for tissue regeneration
Professor who dedicated forty years to improving oral health 'humbled' to be recognised in New Year Honours
2024-12-31 - 2025-01
A Professor who has contributed to understanding and improving oral health for more than 40 years says when he found out he was being recognised in the New Year Honours list he thought it was a hoax.
Emeritus Professor Murray Thomson, an extensively published and multi-award-winning oral health researcher, has been made a Companion of the New Zealand Order of Merit.
His contributions have been vital to understanding oral health of the ageing population and the effectiveness of dental care in improving the lives of children and families.
Thomson has taught and mentored more than 30 year’s worth of dental students over the course of his career.
But despite all his work, Thomson said when he first heard he would be recognised it came as a "complete surprise".
"I know it's cliche to say but it's tremendously humbling - it bowled me over."
Thomson was notified of the recognition while he was in a motor home in Tasmania.
"I checked my email and at first I thought it was a hoax, it came as a complete shock. Literally stunned."
Thomson grew up in Huntly and once he graduated from dental school, he went back there to work as a dentist.
"From my time there, I've always been acutely aware of oral health and equality and it set me on the path of dental health and epidemiology.
"It made me think there was more I could do rather than doing dentistry on one person at a time. It's been quite a journey since."
He spent time working in public health in the UK before returning to New Zealand and looking at dental health in nursing homes in Manawatu and Horowhenua.
"I've dabbled ever since in the oral health of older people but I was always diverting to other areas, I'm towards the end of my career now and I'm editing a journal on the oral health of older people and it's a very rewarding and interesting thing to do and I'm loving it.
"It's a good way to cap off my career."
Health inequality was political, Thomson said, and there was a narrative that it was easier for society to blame the victims than to actually work out what needed to be done to give people better opportunities.
Thomson said he would not have been given an honour without the help of an "immense" number of people he has worked with over the years.
"I've had the privilege to have a lot of fun doing it throughout my career and it's wonderful to be able to pay it forward by training and mentoring my post graduate students who are now working and researching poor oral health in the community.
"It's great to see people now go on and become the people who are leading the scientific investigations."
MP reflects on 2024 as federal dental plan helps thousands in Bay-Superior North access care for first time
2025-01-05 - 2025-01
The Canadian Dental Care Plan is a game-changer for some communities.
Thousands of people in Thunder Bay-Superior North "are getting dental care for the first time" in decades thanks to the federal program that started earlier this year, Patty Hajdu, Member of Parliament and federal cabinet minister of Indigenous services since 2021, said in hindsight of 2024.
In a year-end interview with Dougall Media, Hajdu, who also serves as the member of Parliament for Thunder Bay-Superior North, highlighted the Canadian Dental Care Plan as one of the government's key accomplishments, emphasizing its impact on communities.
"The Canadian Dental Care Plan is a great example of something that I think is producing results for people right here in our riding," Hajdu said.
While acknowledging that adoption took time, Hajdu reported widespread participation from dental professionals.
"What we're seeing is probably close to 85 per cent of dentists across the country are now accepting the Canadian Dental Care Plan," she said.
The program is designed to help eligible Canadians access affordable oral health care, addressing a critical gap in the health-care system. With growing participation from dental practitioners, Hajdu expressed optimism about the program's future and its continued ability to meet the needs of underserved populations.
Looking ahead to 2025, Hajdu wants to see her First Nation's drinking water and wastewater legislation pass into law.
Non-opioid pain relievers beat opioids after dental surgery, trial shows
2025-01-07 - 2025-01
A combination of acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) controls pain after wisdom tooth removal better than opioids, according to a US study.
The trial involving more than 1800 patients by a team at Rutgers in New Jersey-and published in The Journal of the Dental American Association-found that those given a combination of ibuprofen and acetaminophen experienced less pain, better sleep and higher satisfaction compared with those receiving the opioid hydrocodone with acetaminophen.
"We think this is a landmark study. The results actually came in even stronger than we thought they would," lead author Dr Cecile Feldman said.
"There are studies out there to show that when young people get introduced to opioids, there's an increased likelihood that they're going to eventually use them again, and then it can lead to addiction," study co-investigator Dr Janine Fredericks-Younger added.
To compare opioid and non-opioid pain relief, the researchers conducted a randomised trial on patients undergoing surgical removal of impacted wisdom teeth, a common procedure that typically causes moderate to severe pain.
Half the patients received hydrocodone with acetaminophen. The other half got a combination of acetaminophen and ibuprofen. Patients rated their pain levels and other outcomes, such as sleep quality, over the week following surgery.
Results showed the non-opioid combination provided superior pain relief during the peak-pain period in the two days after surgery. Patients taking the non-opioid medications also reported better sleep quality on the first night and less interference with daily activities throughout recovery.
Patients who received the over-the-counter combo were only half as likely as the opioid patients to require additional 'rescue' pain medication. They also reported higher overall satisfaction with their pain treatment.
"We feel pretty confident in saying that opioids should not be prescribed routinely and that if dentists prescribe the non-opioid combination, their patients are going to be a lot better off," Dr Feldman said.
AI and cloud technologies: Enabling the future of health and dental care
2025-01-08 - 2025-01
The intersection of AI and cloud computing has become a transformative force in the health technology and dental care sectors. As these technologies mature, their integration is changing healthcare and dentistry, driving innovations in predictive analytics, personalized patient care, and operational efficiency. This shift is not just technological but also fundamentally patient-centered, promising better outcomes, enhanced accessibility, and improved patient experiences.
Predictive Analytics: Shaping Proactive Healthcare and Dental Care
Predictive analytics, powered by AI and cloud platforms, is revolutionizing healthcare and dental care by enabling providers to anticipate and mitigate risks before they become critical issues. Using ML algorithms, health and dental tech companies can analyze vast amounts of data to identify patterns, trends, and anomalies. This capability has been instrumental in the early detection of diseases, resource allocation, and public health management.
For instance, wearable devices like Fitbit and Apple Watch collect continuous health data such as heart rate, activity levels, and sleep patterns. When integrated with cloud-based AI systems, these devices can alert users and healthcare providers to potential health issues, such as atrial fibrillation, well before symptoms manifest. In dentistry, AI-powered imaging tools like Pearl and Denti.AI analyze dental X-rays to predict the onset of cavities, gum disease, or oral cancer, providing dentists with actionable insights for early intervention.
In the realm of pandemic management, AI-driven predictive models hosted on cloud platforms proved critical during COVID-19. Models analyzed data streams from hospitals, labs, and governmental sources to predict infection surges, enabling more effective resource deployment, such as ventilators and ICU beds. Similarly, dental clinics used AI tools to predict patient volume surges and manage appointment scheduling, ensuring patient safety while maintaining operational continuity.
Patient Personalization: A New Era of Tailored Medicine and Dentistry
Personalized care, the tailoring of treatments to individual patients, has advanced significantly with the advent of AI and cloud technologies. The combination enables the analysis of genetic, environmental, and lifestyle data to design bespoke treatment plans, improving outcomes and reducing adverse reactions.
AI-driven genomics, for example, uses cloud infrastructure to process terabytes of genetic data quickly. Companies like Illumina leverage these technologies to offer insights into a patient's genetic predisposition to diseases like diabetes or cancer. By analyzing genetic markers, AI algorithms can suggest preventive measures or targeted therapies, such as immunotherapies for cancer treatment.
In dental care, AI is enabling customized treatment planning for orthodontics and restorative procedures. Tools like Invisalign's AI-powered ClinCheck system analyze patient-specific de
Practical steps for a sustainable dental practice
2025-01-09 - 2025-01
TePe explains how dental practices can adopt a more sustainable approach and discusses its own developing sustainability strategy.
The global healthcare sector is responsible for around 5% of greenhouse gas emissions (Seppanen, 2024). With the increasing demand for care from patients, it is predicted that this figure will continue to grow unless there is a significant change in how healthcare providers operate. As a result of this figure, many dental professionals are consciously looking for solutions to better their environmental footprint.
Several attainable methods can be implemented to achieve this goal.
Reducing single-use plastics
Promoting the adoption of reusable and/or biodegradable products is a vital step to improving sustainability in a dental practice. Although it is not always possible to find such dental products that remain suitable for use in clinic, TePe encourages all healthcare professionals to educate patients on how they can select and use sustainable dental products at home.
TePe offer a range of dental products that afford customers multiple-use and/or sustainably sourced cleaning solutions. These products include, but are not limited to:
TePe Interdental Brushes have been manufactured using high-quality, traceable bio-resin, allowing for these products to last through multiple cleaning sessions at home (provided the product has been correctly used and cleaned between each use
The TePe Choice Toothbrush allows customers to replace the plastic brush head, rather than purchasing a new toothbrush every three to four months. The handle, on the other hand, is made from Swedish-grown beechwood and ISCC-certified plant-based material. By encouraging patients to opt for a sustainable toothbrush, such as TePe Choice, plastic waste is reduced by 80% compared to the average plastic toothbrush
TePe GOOD Brushes offer patients a selection of brush heads - either regular soft, compact or mini. These toothbrushes are made from 96% bio-based plastic, which offers an alternative to other plastic-based brushes available on the market. The filaments are made from bio-based polyamide, meaning they are made from renewable resources, in this case, castor oil.
*Please note - TePe Interdental Brushes are suitable for multiple uses at home, not within a clinic via the use of an autoclave.
By educating patients, healthcare professionals will not only strengthen community and patient engagement (by raising the ecological profile of the clinic) - but can also reduce the patient's individual contribution to the overall figure of emissions created by the healthcare industry.
Preventative care at home
One of the most effective ways to reduce emissions is by encouraging effective at-home-care methods and solutions to patients. Not only will this benefit the individual patient in terms of cost, and physical (and mental) wellbeing, but it will also strengthen community and patient engagement (whilst also raising the ecological profile of the cl
New Dental Registration Rules Require Internships for Graduates Starting April 1, Enhancing Clinical Experience and Standards.
2025-01-16 - 2025-01
Internship and period of assessment arrangement under Dentists Registration Ordinance to take effect from April 1
The Government announced today (January 16) that the provisions on provisional registration, internship and period of assessment in the Dentists Registration Ordinance (DRO) (Cap. 156) will come into effect from April 1. By that date, local dental graduates will need to undergo an internship with provisional registration, while non-locally trained dentists who have passed the licensing examination of the Dental Council of Hong Kong (DCHK) will also need to undergo a period of assessment with provisional registration, before they can obtain full registration in Hong Kong. This arrangement can enrich the clinical experience of local dental graduates and non-locally trained dentists, thereby better protecting citizens utilising dental services.
Following the passage of the Dentists Registration (Amendment) Bill 2024 by the Legislative Council last July, the Government subsequently tabled the second commencement notice at the Legislative Council last December for negative vetting. The vetting period ended yesterday (January 15).
As indicated by the Government during the legislative process, unlike the practice for medical practitioners, there is currently no statutory requirement for dentists to undergo an internship or a period of assessment prior to registration. The requirements for an internship/a period of assessment have been introduced in the DRO in response to feedback from the dental profession in recent years regarding enhancing the practical clinical experience of local dental graduates and non-locally trained dentists in real-life settings. This arrangement will be highly beneficial for further enhancing dentists' professional standards.
Interns/assessees will obtain the status of provisional registration, and will be appointed as dentists under contractual terms (salary level at 50 per cent of Master Pay Scale Point 30 for civil servants, i.e. $35,505 per month in the 2024-25 financial year) to undergo an internship/a period of assessment. During this time, they will work in rotation at various service units under the guidance of experienced dentists, including:
(1) School Dental Care Service;
(2) emergency dental service;
(3) hospital dental service (such as specialist services of oral maxillofacial surgery);
(4) community dental service (such as dental services designated for the underprivileged); and
(5) general dental service (such as government dental services).
Interns/assessees will become familiar with the practice in Hong Kong and hone their communication skills with local patients to prepare themselves for effectively handling the work of a practising dentist. Upon successful completion of their internship/period of assessment, they will be awarded a certificate of experience that enables them to obtain full registration.Pursuant to the DRO, an internship/a period of assessment generally lasts for 12 month
Study Reveals Tylenol and Advil Outperform Opioids for Wisdom Tooth Pain
2025-01-10 - 2025-01
A Rutgers study shows acetaminophen and ibuprofen outperform opioids for pain relief after wisdom tooth removal, leading to better outcomes and supporting ADA guidance to avoid opioids as first-line treatment.
A study by Rutgers Health has found that a combination of acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) is more effective at managing pain after wisdom tooth removal than opioids.
The trial, which included over 1,800 patients, revealed that those treated with the acetaminophen-ibuprofen combination reported less pain, improved sleep, and greater overall satisfaction compared to those who received hydrocodone with acetaminophen, an opioid-based pain relief option. This research could influence dentists to prioritize non-opioid pain management strategies for post-surgical care.
"We think this is a landmark study," said Cecile Feldman, dean of Rutgers School of Dental Medicine and lead author of the study. "The results actually came in even stronger than we thought they would."
Addressing Opioid Over prescription in Dentistry
Dentists, who rank among the nation's leading prescribers of opioids, wrote more than 8.9 million opioid prescriptions in 2022. For many young adults, dental procedures such as wisdom tooth extraction are their first exposure to opioid medications.
"There are studies out there to show that when young people get introduced to opioids, there's an increased likelihood that they're going to eventually use them again, and then it can lead to addiction," said study co-investigator Janine Fredericks-Younger, adding that opioid overdoses kill more than 80,000 Americans each year.
To compare opioid and non-opioid pain relief, the researchers conducted a randomized trial on patients undergoing surgical removal of impacted wisdom teeth, a common procedure that typically causes moderate to severe pain.
Half the patients received hydrocodone with acetaminophen. The other half got a combination of acetaminophen and ibuprofen. Patients rated their pain levels and other outcomes, such as sleep quality, over the week following surgery.
Results in The Journal of American Dental Association showed the non-opioid combination provided superior pain relief during the peak-pain period in the two days after surgery. Patients taking the non-opioid medications also reported better sleep quality on the first night and less interference with daily activities throughout recovery.
Key Findings: Non-Opioids Are Safer and More Effective
Patients who received the over-the-counter combo were only half as likely as the opioid patients to require additional "rescue" pain medication. They also reported higher overall satisfaction with their pain treatment.
"We feel pretty confident in saying that opioids should not be prescribed routinely and that if dentists prescribe the non-opioid combination, their patients are going to be a lot better off," Feldman said.
The study's size and design make it particularly notable. With more than 1,800
Hierarchy in dentistry: A dental nurse perspective
2025-01-17 - 2025-01
The division within a dental practice can be frustrating for dental nurses, who are often seen as being at the bottom of the hierarchy despite playing a vital role in patient care and practice operations, says Rebecca Silver.
Hierarchy in dentistry refers to the structured order of roles and responsibilities within an oral healthcare team, typically organised by qualifications, authority, and clinical expertise. Dentists usually sit at the top, with dental hygienists, dental therapists, and dental nurses in more supportive roles. While this structure ensures the smooth running of a practice, it can also create power imbalances and communication barriers, affecting both the team and patient care. In most privately owned dental practices, dentists are both the owners and the primary decision-makers. This naturally elevates their position within the team, giving them more control over both clinical and business decisions. One could argue that this elevated role creates added pressure, as they not only need to ensure the clinical success of the practice but also its financial viability. Larger practices may bring in a practice manager to help ease the load, but this adds another layer to the hierarchy. Whether or not the manager has clinical experience can significantly influence the way the practice operates and how the team functions.
The role of practice managers in the hierarchy
Practice managers can either bridge the gap or exacerbate the hierarchy, depending on their clinical background. A manager with clinical experience may understand the day-to-day realities of the team, fostering a smoother operation. However, a non-clinical manager may struggle to connect with the team's needs, causing potential frustration or disconnection. This division can be particularly frustrating for dental nurses, who are often seen as being at the bottom of the hierarchy despite playing a vital role in patient care and practice operations.
Dental nurses are key to keeping the practice running - handling infection control, managing equipment, ordering supplies, and building relationships with patients. Yet, their contribution is frequently undervalued in terms of both recognition and compensation. Despite their critical role, many dental nurses find themselves feeling overlooked.
Communication breakdown and power imbalances
The undervaluation and under compensation of dental nurses
Professional inequality is a direct result of hierarchical structures that undervalue support staff. This not only affects the financial aspect of the role but also limits career progression. Dental nurses are often seen as less skilled or secondary to other clinical staff, which can prevent them from accessing opportunities for further professional development. As a result, many leave the profession entirely or seek other roles within dentistry that offer better pay and recognition.
On social media, it's not uncommon to see discussions among dental nurses about being asked to op
Occupational pain in the dental profession
2025-01-20 - 2025-01
Aches, pains, sore necks and bad backs are common complaints of suffering dentists. What can be done to prevent or minimize these pains? By Kerryn Ramsey
Occupational chronic pain is a common experience for many dentists. Holding posture for long periods, bending and stretching in an unnatural manner, sitting incorrectly on a stool or chair, and grasping and using instruments for long periods, can all be contributing factors.
The recent National Workspace Week revealed that work-related musculoskeletal disorder (WMSD) is the most frequent work, health and safety issue impacting Australian workers at a cost of $55.1 billion annually to the Australian economy.
With such high numbers of dentists affected by WMSD, it's clear that more education and awareness about the issue is required in the dental profession. Peak bodies such as the ADA need to be involved, and universities should include information in their curriculum.
Dr Penelope Jones is an endodontist and founder of Working Posture, a company providing WMSD solutions specifically for dentists. She believes that all dental schools need to make musculoskeletal wellness a part of basic training. Regular CPD courses would also help improve things.
"Surgeries need to be professionally ergonomically assessed, and dentists need to learn how to move their bodies correctly," she says. "You can have the Rolls Royce of dental equipment and still harm yourself. “Unfortunately, it is the very nature of the job that causes many dentists to be affected by WMSD.
"While things are slowly improving, we can never make the work inherently risk-free," says
Dr Jean Wu, a dentist and clinical Pilate’s teacher who's undertaking research into WMSD at the University of Melbourne. "Prevention is a far better option than cure, and education and awareness should be promoted. Ultimately, all dental professionals have a personal responsibility to find methods that work for them."
Awareness, training and intervention instituted early in a dentist's career provides the best outcomes. Dr Aniko Ball, a dentist and founder of Optimum Dental Posture, a company dedicated to reducing the risk of occupational chronic pain, would also like to see training at a university level. "Learning how to sit properly is one of the most important skills a dentist can have," she says. "It's about improving the quality of your work and life. It needs to be taken seriously."
Minimize risk
Fortunately, there are ways for dentists to mitigate and avoid these issues. A good start is to recognize the problem and deal with the cause.
"Ignoring pain can lead to that part of their body going numb," says Dr Jones. "Sufferers lose proprioception, the ability to sense movement, action and location. Hurting yourself without realizing it's happening is very serious."
The impact of WMSD goes far beyond just the physical. People living with pain frequently find their mental health suffering and may even lose their sense of humor.
"Surprisingly, y
Septodont invests in Balanced Pharma to commercialize new pain-relief dental injection drugs
2025-01-20 - 2025-01
Balanced Pharma Inc. (BPI), a North Carolina-based company, has recently announced that France-based Septodont has made a strategic investment to support the commercialization of its new dental injection drugs.
BPI also said that Septodont COO Atif Zia has joined its Board of Directors.
"We are very proud to add Septodont to the growing list of dental industry members investing in the development of these important products and to have Atif [Zia] as part of our leadership team," said Dr. Scott Keadle, a retired dentist and CEO of Balanced Pharma.
To date, BPI has raised about $6.5 million of its current $8-million funding round. When closed, this round will bring total investment in the company to approximately $12 million, including more than $9 million from dentists and other dental industry insiders.
The company's goals include offering multi-day pain relief to reduce opioid use following orthopedic and oral surgery, as well as developing faster, less painful, and more reliable local anesthesia for dental procedures.
Flagship dental drugs: BPI-001 and BPI-002
Balanced Pharma's flagship products, BPI-001 and BPI-002, are reformulated versions of the injectable anesthetics lidocaine and articaine. Both feature improved salt and acid balance to reduce pain, speed up onset, and enhance reliability.
The drugs will be packaged in standard dental cartridges, eliminating the need for new equipment or clinical protocol changes. The company plans to launch BPI-001 in the U.S. by the fourth quarter of 2027, followed by BPI-002 and expansion into global markets. BPI estimates the two products will compete in a U.S. retail market valued at $2.9 billion annually.
Non-opioid analgesic BPI-004
Another product, BPI-004, is a non-opioid injectable analgesic combining tetracaine (0.2%), lidocaine (0.4%), and epinephrine (1:250,000). When administered during surgery, BPI-004 is designed to provide up to three days of pain relief with low toxicity, minimal motor impairment, and reduced opioid reliance.
Balanced Pharma aims to bring BPI-004 to the U.S. market by the second quarter of 2025 under a 503(b) exemption. The company expects it to compete with bupivacaine and liposomal bupivacaine in the U.S. retail market, which is valued at $9 billion annually.
BPI's proprietary technology platform was developed by a dentist and supports new injectable anesthetic and analgesic drugs for various applications, including orthopedic, general, and oral surgeries, as well as general dentistry.
Acquiring rights to non-opioid drug
The news comes amid the U.S. and Canadian opioid crisis. And this partly explains why BPI in November acquired the rights to Enduracidin Dental, a non-opioid injectable pain relief drug for post-surgical use in dentistry.
After all, dentists rank among the leading prescribers of opioids, having written more than 8.9 million opioid prescriptions in the United States in 2022, contributing to a heightened risk of dependency. Additionally, Ca
